On Boxing Day, 2017, a single, fiery car crash near Sussex Inlet on NSW’s south coast lent four names to the national road toll. Among the dead, three members of the Falkholt family: parents Lars and Vivian and their 21-year-old daughter, Annabelle, who died in a Sydney hospital on Friday.
What was, at first, just another holiday tragedy, soon earned ongoing international attention when it was revealed the sole survivor was Home and Away star, Jessica Falkholt, 28, who is currently fighting for her life after multiple surgeries.
Then came details about the fourth victim, the person behind the wheel of the 4WD that struck them head on. His name was Craig Whithall, he was 50 years old, a P-plater, a father, a grandfather and, crucially, a methadone user.
That’s when the tone shifted.
While the cause of the crash is still being investigated by authorities, media reports highlighted that the Ulladulla man had been returning from a Nowra methadone clinic at the time.
The revelation sparked crisis talks between NSW Roads Minister and senior police over the weekend about users being allowed behind the wheel after methadone treatment – a topic tabled as part of a broader discussion on the state’s climbing road toll (392 people died on the state’s roads in 2017, 12 more than the previous year).
It’s a debate that’s happened many times since methadone treatment was officially adopted in Australia in 1970. But is there really cause for concern?
First of all, what is methadone and why is it used?
Methadone is a synthetic, prescription opioid used in management of severe pain and also as a treatment for people addicted to similar drugs, such as heroin.
Because it acts the same way as illicit opioids in the body but with fewer associated harms, it’s commonly administered as a replacement drug to help people break their dependence. This may involve a short-term withdrawal program, generally 5-14 days, or a long-term maintenance program that may last months or years.
Generally taken orally once a day, methadone is available through clinics, pharmacies, hospitals and prisons throughout Australia.
To obtain a methadone prescription in NSW, for example, a doctor must assess the patient as suitable and the NSW Ministry of Health must authorise the application to commence treatment. Clients are regularly reviewed by their doctors and prescriptions are renewed as required.
Government research found there were over 34,000 Australians using opioid substitution treatments, including methadone, in 2016 – that’s excluding Victoria and Tasmania for which data wasn’t available. Those 34,000 people accessed the treatment via 1,472 prescribing points, most of which were pharmacies.